Senate Republicans failed to pass Obamacare repeal. Now what?

The Senate has rejected a measure to repeal parts of former President Barack Obama's health law, dealing a serious blow to President Donald Trump and the GOP agenda. The final vote was 51-49. (July 28)
AP

WASHINGTON — The GOP’s seven-year crusade to repeal and replace Obamacare disintegrated in the wee hours of Friday morning. So now what?

Republicans were asking themselves that very question as they tried to make sense of the Senate’s stunning vote, when three GOP senators joined all the chamber’s Democrats to sink a bare-bones repeal bill. That flop followed two others earlier in the week, as Republicans failed to muster 51 votes for any bill aimed at unraveling the Affordable Care Act.

“We’re evaluating the options. That’s literally where we are right now,” Rep. Greg Walden, R-Ore., chairman of a key House health committee, told reporters Friday morning.

Here’s a look at a few of those options and how they might play out:

Republicans can give up on health care and move to other issues

That seemed to be the message from Senate Majority Leader Mitch McConnell, R-Ky., after Friday’s roll call was over.

“Our only regret tonight is that we didn't achieve what we had hoped to accomplish," McConnell said. "It’s time to move on."

Without question, Republicans have a boatload of other pressing issues to tackle —including a must-pass defense measure, annual funding bills to keep the government open, and tax reform. Republicans need a legislative victory, and so far they’ve spent an exasperating seven months on health care with nothing to show for it.

So it’s no wonder if some lawmakers are eager to turn the page.

“Right now, we have very little to go home and talk about,” said Rep. Mark Walker, R-N.C. “We have not delivered.”

Republicans can try again and hope for a different result

“It’s not a death knell,” insisted Rep. Mark Meadows, another North Carolina Republican and the chairman of the House Freedom Caucus, a band of arch-conservatives. He said Republicans would “regroup and stay focused” on repealing and replacing the 2010 laws.

Meadows said he was hopeful that Republicans could revive some remnants of the now-moribund Senate GOP bill. Two of the most viable options, according to Meadows:

• A proposal by Sen. Ted Cruz, R-Texas, to allow insurance companies to offer bare-bones insurance plans as long as they also offer the more comprehensive coverage required under Obamacare.

• A bill crafted by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., that would keep much of the Obamacare taxes in place but send that money to the states in the form of block grants so governors can decide how to use it.

Other Republicans echoed Meadow’s optimism and said they could not walk away from their years-long promise to unravel the Affordable Care Act.

“We can’t give up on health care,” said Rep. Barry Loudermilk, R-Ga. “It may take a dozen more times,” he said, but the GOP will pick of the pieces from Friday’s mess and soldier on.

Republicans can fight with each other over who is to blame for the repeal-and-replace collapse

Republicans have been consumed by infighting for much of health care debate — with moderates battling conservatives over how far to go in repealing Obamacare and leading to Friday’s stalemate. Whether the GOP can move past those battles — or whether they will deepen — is not clear.

Republicans can sit down with Democrats and try to craft a bipartisan compromise

Democrats, along with a handful of moderate Republicans, said Friday’s vote should be seen as an opportunity to start from scratch with committee hearings, public debate and, yes, bipartisanship. The Senate GOP bill was crafted behind closed doors by Republican leaders, with little time for lawmakers to review it and almost no public debate.

“It is now time to return to regular order with input from all of our members — Republicans and Democrats — and bring a bill to the floor of the Senate for amendment and debate,” McCain said in a statement Friday. “I encourage my colleagues on both sides of the aisle to trust each other, stop the political gamesmanship, and put the health care needs of the American people first. We can do this.”

Senate Democrats said they were ready to work with Republicans — if the GOP would drop the effort to repeal Obamacare and work on shoring the law up instead. There are a number of bipartisan talks underway in the Senate, with the most immediate focus on trying to stabilize the individual insurance markets, which have been rattled by the GOP debate.

Senate Minority Leader Chuck Schumer of New York on Friday said he wanted to start with a proposal to guarantee federal subsidies to insurance companies, an Obamacare provision that helps insurers offer low-income families plans with reduced out-of-pocket costs, such as deductibles and copays. Another would involve “re-insurance,” in which the federal government would subsidize insurers for costs above a certain amount.

It’s unclear how Republicans will receive those ideas. McConnell said Thursday, during a Senate floor speech, that Schumer just wanted to “throw money at insurance companies.”

“No reforms, no changes, just a multibillion-dollar Band-Aid,” he said.

But other Republicans said they had to negotiate with Democrats, and stabilizing the markets would be a good starting place.

“There’s a lot that went wrong. They should have never tried to force this on a partisan basis," said Rep. Charlie Dent, R-Pa.